227882 Effect of a city-wide smoking ban on maternal smoking prevalence and risk of preterm and low birth weight births: The Colorado experience

Tuesday, November 9, 2010 : 9:05 AM - 9:20 AM

Robert Page II, PharmD, MSPH, FCCP, FAHA, FASHP, BCPS , Departments of Clinical Pharmacy and Physical Medicine, University of Colorado School of Pharmacy and School of Medicine, Aurora, CO
Julia F. Slejko, PhD candidate , Departments of Clinical Pharmacy, University of Colorado Denver School of Pharmacy, Aurora, CO
Anne Libby, PhD , School of Pharmacy, University of Colorado Denver, Aurora, CO
Objectives: There exists a gap in the evidence regarding the association of maternal second hand smoke exposure and low birth weight (LBW) and preterm births. No data exist on the association of a public smoking ban on these fetal outcomes in the US. Methods: In this retrospective, observational study, we assessed maternal smoking prevalence and risk of LBW (< 2500g or <3000g) and preterm births (< 37 weeks gestation) in singleton births from mothers residing in Pueblo, Colorado (n=6,714) before (April 1, 2001 to July 1, 2003) and after (April 1, 2004 to July 1, 2006) a city-wide smoking-ban. During the incident time-period, these data were compared with another geographically isolated but proximal community, El Paso County, Colorado (n=32,281) with no such ordinance. Descriptive statistics and multivariable logistic regressions were used adjusting for multiple covariates. Results: Compared to El Paso, Pueblo experienced a 3% decline in maternal smoking (P=0.0002) and a 20% decline in preterm births (adjusted OR: 0.80, 95% CI: 0.662 - 0.983) pre and post smoking ban. The risk of LBW births declined by 12 % (adjusted OR: 0.88, 95% CI: 0.790 - 0.992) and 9% (adjusted OR: 0.91, 95% CI: 0.745 - 1.099) using the <2500g and < 3000g definitions for LBW, respectively. Conclusions: Our study results are the first to suggest an association between the institution of a smoking ban and a reduction in preterm but not LBW births. These data suggest the benefits of such smoking ordinances on fetal and maternal health.

Learning Areas:
Administer health education strategies, interventions and programs
Environmental health sciences
Epidemiology
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related public policy

Learning Objectives:
1. Using the city-wide smoking ban in Pueblo, CO compared to an adjacent control county with no ordinance, delinate the effect of a smoking ban on maternal smoking prevalance as well as the risk of low birth weitht and perterm births.

Keywords: Pregnancy Outcomes, Environmental Exposures

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As an Associate Professor at the University of Coloardo, I am qualified to present as I am currently involved in developing and implementing health policy at the state level. Furthermore, I have a MSPH with an epidemiology focus and conduct research in heath services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.